Provider Demographics
NPI:1407034796
Name:LETT, PEGGY ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:ANN
Last Name:LETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 S MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-5130
Mailing Address - Country:US
Mailing Address - Phone:586-336-0910
Mailing Address - Fax:810-798-2680
Practice Address - Street 1:231 S MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-5130
Practice Address - Country:US
Practice Address - Phone:586-336-0910
Practice Address - Fax:810-798-2680
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008629101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional